BUCKEYE LAWN SERVICE INC.
Employment Application
NAME: _________________
DATE: _________________
Buckeye Lawn Service Inc. is an equal opportunity/affirmative action employer. All qualified applicants will be considered without regard to age, race, color, sex, religion, nation origin, marital status, ancestry, citizenship, veteran status, sexual orientation or preference, or physical or mental disability.
THIS SECTION FOR OFFICE USE:
DRIVING RECORD ____________________
DATE HIRED ____________________
START DATE & TIME ____________________
WAGE HIRED ____________________ TIME IN
SCHOOL FULL TIME PART TIME
SMOKE GO WITHOUT
Personal
|
|
|
|
Last Name First Initial
|
Social Security # ____-___-______
Birth date: ____/____/_____
|
|
Other Name(s) Used
|
Home Telephone #
( )
|
|
Address City State Zip
|
Business or Message or cell #
( )
|
|
Position Applied For
|
Referred By
|
Salary Desired or $ per hour
|
|
Have you ever interviewed with the Company or its affiliates before? ¨ Yes¨ No
|
If yes, list date(s), job title(s) & location(s)
|
|
Have you ever been employed by the Company or its affiliates before? ¨ Yes¨ No
|
If yes, list date(s), job title(s) & location(s)
|
|
Do you have any relatives employed by the Company or its affiliates? ¨ Yes¨ No
|
If yes, list date(s), job title(s) & location(s)
|
|
Are you at least 18 years old?
¨ Yes¨ No
|
If under 18, do you have a work permit?
|
|
|
|
|
|
Education
|
|
|
|
|
Circle Highest Grade Completed: High School 9 10 11 12
College, Trade or Business 1 2 3 4
Graduate Studies
|
|
School
|
Address
|
Major Studies
|
Degree, Diploma,
License or Certificate
|
|
High School
|
|
|
|
|
College/University
|
|
|
|
|
Vocational, Business, Other
|
|
|
|
|
List Any Professional Designations
|
|
Other Special Knowledge, Skills or Qualifications
|
|
For Clerical Applicants Only:
|
|
Do you type? ¨ Yes ¨ No If yes, WPM:
|
|
Computer Skills (Hardware/Software)
|
|
Employment History
|
|
List all employments for the past 10 years, starting with the most recent position. All information must be completed. You may attach a resume, but not in place of completing the required information.
|
|
Employed From
/ /
|
Employer Name
|
Supervisor Name
|
Starting Salary
|
|
Employed Until
/ /
|
Employer Address
|
Supervisor Phone #
|
Ending Salary
|
|
Job Title
|
Reason for Leaving
|
|
Duties & Responsibilities
|
|
|
|
Employed From
/ /
|
Employer Name
|
Supervisor Name
|
Starting Salary
|
|
Employed Until
/ /
|
Employer Address
|
Supervisor Phone #
|
Ending Salary
|
|
Job Title
|
Reason for Leaving
|
|
Duties & Responsibilities
|
|
|
|
Employed From
/ /
|
Employer Name
|
Supervisor Name
|
Starting Salary
|
|
Employed Until
/ /
|
Employer Address
|
Supervisor Phone #
|
Ending Salary
|
|
Job Title
|
Reason for Leaving
|
|
Duties & Responsibilities
|
|
|
|
Employed From
/ /
|
Employer Name
|
Supervisor Name
|
Starting Salary
|
|
Employed Until
/ /
|
Employer Address
|
Supervisor Phone #
|
Ending Salary
|
|
Job Title
|
Reason for Leaving
|
|
Duties & Responsibilities
|
|
|
Yes No
¨ ¨ May we contact your current employer for references?
¨ ¨ if hired, will you be able to work overtime?
¨ ¨ Will you be able to perform the essential job functions for the position you are applying for with or without reasonable accommodation?
¨ ¨ Have you ever been convicted of a crime, excluding misdemeanors and summary offenses, which has not been annulled, expunged or seals by court? (A yes response does not automatically disqualify your application.)
|
Certification & Authorization
|
The above information is true and correct. I understand that, in the event of my employment by the Company, I shall be subject to dismissal if any information that I have given in this application is false or misleading or if I have failed to give any information herein requested, regardless of the time elapsed after discovery.
I authorize the Company to inquire into my educational, professional and past employment history references as needed to research my qualifications for this position. I hereby give my consent to any former employer to provide employment-related information about me to the Company and will hold the Company and my former employer harmless from any claim made on the basis that such information about me was provided or that any employment decision was made on the basis of such information. I further authorize the Company to obtain any credit and consumer check.
I understand that nothing in this employment application, the granting of an interview or my subsequent employment with the Company is intended to create an employment contract between myself and the Company under which my employment could be terminated only for cause. On the contrary I understand and agree that, if hired; my employment will be terminable at will and may be terminated by me or the Company at any time and for any reason. I understand that no person has any authority to enter into any agreement contrary to the foregoing.
If employed, I will be required to provide original documents which verify my identity and right to work in the United States under the Immigration Reform and Control Act (IRCA) of 1986. The document(s) provided will be used for completion of Form I-9.
If employed, I agree that the following reasons will result in any hours owed to be dispensed at the current minimum wage: Not giving a two-week written notice, a positive substance abuse test or termination for any just cause reason.
I hereby acknowledge that I have read and agree to the above statements.
|